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[PMID]:25816384
[Au] Autor:Bloom M; Markovitz S; Silverman S; Yost C
[Ad] Endereço:Massachusetts General Hospital Cancer Center, Boston, MA, USA.
[Ti] Título:Ten trends transforming cancer care and their effects on space planning for academic medical centers.
[So] Source:HERD;8(2):85-94, 2015.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This article aims to define the major trends currently affecting space needs for academic medical center (AMC) cancer centers. It will distinguish between the trends that promote the concentration of services with those that promote decentralization as well as identify opportunities for achieving greater effectiveness in cancer care space planning. BACKGROUND: Changes in cancer care-higher survival rates, increased clinical trials, new technology, and changing practice models-increasingly fill hospitals' and clinicians' schedules and strain clinical space resources. Conflicts among these trends are concentrating some services and dispersing others. As a result, AMCs must expand and renovate intelligently to continue providing state-of-the-art, compassionate care. CONCLUSIONS: Although the typical AMC cancer center can expect to utilize more space than it would have 10 years ago, a deeper understanding of the cancer center enterprise can lead to opportunities for more effectively using available facility resources. Each AMC must determine for itself the appropriate balance of patient volume, clinical activity, and services between its main hospital campus and satellite branches. As well, space allocation should be flexible, as care trends, medical technology, and the provider's own priorities shift over time. The goal isn't necessarily more space-it's better space.
[Mh] Termos MeSH primário: Centros Médicos Acadêmicos/tendências
Decoração de Interiores e Mobiliário/normas
Neoplasias/terapia
Serviço Hospitalar de Oncologia/tendências
Ambulatório Hospitalar/tendências
Cuidados Paliativos/tendências
Equipe de Assistência ao Paciente/tendências
Medicina de Precisão/tendências
[Mh] Termos MeSH secundário: Tecnologia Biomédica/tendências
Ensaios Clínicos como Assunto/métodos
Ensaios Clínicos como Assunto/estatística & dados numéricos
Hospitais Satélites/tendências
Seres Humanos
Decoração de Interiores e Mobiliário/métodos
Determinação de Necessidades de Cuidados de Saúde
Neoplasias/epidemiologia
Equipe de Assistência ao Paciente/organização & administração
Relações Profissional-Família
Apoio Social
Sobreviventes/estatística & dados numéricos
Pesquisa Médica Translacional/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/1937586714565598


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[PMID]:28800943
[Au] Autor:Senter L; O'Malley DM; Backes FJ; Copeland LJ; Fowler JM; Salani R; Cohn DE
[Ad] Endereço:Division of Human Genetics, Ohio State University College of Medicine, Columbus, OH, United States. Electronic address: leigha.senter@osumc.edu.
[Ti] Título:Genetic consultation embedded in a gynecologic oncology clinic improves compliance with guideline-based care.
[So] Source:Gynecol Oncol;147(1):110-114, 2017 Oct.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Analyze the impact of embedding genetic counseling services in gynecologic oncology on clinician referral and patient uptake of cancer genetics services. METHODS: Data were reviewed for a total of 737 newly diagnosed epithelial ovarian cancer patients seen in gynecologic oncology at a large academic medical center including 401 from 11/2011-7/2014 (a time when cancer genetics services were provided as an off-site consultation). These data were compared to data from 8/2014-9/2016 (n=336), when the model changed to the genetics embedded model (GEM), incorporating a cancer genetic counselor on-site in the gynecologic oncology clinic. RESULTS: A statistically significant difference in proportion of patients referred pre- and post-GEM was observed (21% vs. 44%, p<0.0001). Pre-GEM, only 38% of referred patients were actually scheduled for genetics consultation and post-GEM 82% were scheduled (p<0.00001). The difference in the time from referral to scheduling in genetics was also statistically significant (3.92months pre-GEM vs. 0.79months post-GEM, p<0.00001) as was the time from referral to completion of genetics consultation (2.52months pre-GEM vs. 1.67months post-GEM, p<0.01). Twenty-five percent of patients referred post GEM were seen by the genetic counselor on the same day as the referral. CONCLUSIONS: Providing cancer genetics services on-site in gynecologic oncology and modifying the process by which patients are referred and scheduled significantly increases referral to cancer genetics and timely completion of genetics consultation, improving compliance with guideline-based care. Practice changes are critical given the impact of genetic test results on treatment and familial cancer risks.
[Mh] Termos MeSH primário: Aconselhamento Genético/organização & administração
Neoplasias dos Genitais Femininos/genética
Fidelidade a Diretrizes/normas
Serviço Hospitalar de Oncologia/organização & administração
Encaminhamento e Consulta/organização & administração
[Mh] Termos MeSH secundário: Adulto
Idoso
Prestação Integrada de Cuidados de Saúde/organização & administração
Feminino
Predisposição Genética para Doença
Neoplasias dos Genitais Femininos/terapia
Acesso aos Serviços de Saúde/organização & administração
Seres Humanos
Meia-Idade
Modelos Organizacionais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170813
[St] Status:MEDLINE


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[PMID]:28687130
[Au] Autor:Charniot C; Berchouchi F; Marchand C; Gagnayre R; Sebbane G; Pamoukdjian F
[Ad] Endereço:Instituts de formation en soins infirmiers et aides-soignants (Ifsi/Ifas), Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 21 avenue de la République, 94205 Ivry sur Seine, France.
[Ti] Título:[Training and action research in a short-stay geriatric oncology unit].
[Ti] Título:Recherche-action et formation dans une unité de court séjour oncogériatrique..
[So] Source:Soins Gerontol;22(126):26-30, 2017 Jul - Aug.
[Is] ISSN:1268-6034
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:A participative action research project was undertaken in a geriatric oncology hospital unit. It resulted in the training of paramedical staff regarding the specific care to be provided to elderly people with cancer.
[Mh] Termos MeSH primário: Pessoal Técnico de Saúde/educação
Enfermagem Geriátrica/educação
Pesquisa sobre Serviços de Saúde
Tempo de Internação
Neoplasias/enfermagem
Enfermagem Oncológica/educação
Serviço Hospitalar de Oncologia
[Mh] Termos MeSH secundário: Atividades Cotidianas/classificação
Idoso
Idoso de 80 Anos ou mais
Currículo
França
Seres Humanos
Comunicação Interdisciplinar
Colaboração Intersetorial
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170709
[St] Status:MEDLINE


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[PMID]:28604320
[Au] Autor:Abratt RP; Eedes D; Bailey B; Salmon C; Govender Y; Oelofse I; Burger H
[Ad] Endereço:Division of Radiation Oncology, Faculty of Health Sciences, University of Cape Town, Cape Town; and Independent Clinical Oncology Network, Cape Town, South Africa. Raymond.Abratt@uct.ac.za.
[Ti] Título:Audits of oncology units - an effective and pragmatic approach.
[So] Source:S Afr Med J;107(6):493-496, 2017 May 24.
[Is] ISSN:0256-9574
[Cp] País de publicação:South Africa
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. OBJECTIVE: To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. METHODS: Staff in oncology units who were part of the audit process completed the audit self-assessment form for the unit. This was followed by a visit to each unit by an assessor, and then subsequent personal contact, usually via telephone. The audit self-assessment document listed quality-assurance measures or items in the physical and functional areas of the oncology unit. There were a total of 153 items included in the audit. The online survey took place in October 2016. The invitation to participate was sent to 59 oncology units at which staff members had completed the audit process. RESULTS: The online survey was completed by 54 (41%) of the 132 potential respondents. The online survey found that the audit was very or extremely useful in maintaining personal professional standards in 89% of responses. The audit process and feedback was rated as very or extremely satisfactory in 80% and 81%, respectively. The self-assessment audit document was scored by survey respondents as very or extremely practical in 63% of responses. The feedback on the audit was that it was very or extremely helpful in formulating improvement plans in oncology units in 82% of responses. Major and minor changes that occurred as a result of the audit process were reported as 8% and 88%, respectively. CONCLUSION: The survey findings show that the audit process and its self- assessment document meet the aims of being helpful and pragmatic.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Auditoria Médica
Serviço Hospitalar de Oncologia
Garantia da Qualidade dos Cuidados de Saúde
[Mh] Termos MeSH secundário: Seres Humanos
Enfermeiras e Enfermeiros
Oncologistas
Enfermagem Oncológica
Administração da Prática Médica
África do Sul
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.7196/SAMJ.2017.v107i6.12356


  5 / 1339 MEDLINE  
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[PMID]:28544310
[Au] Autor:Scialla MA; Canter KS; Chen FF; Kolb EA; Sandler E; Wiener L; Kazak AE
[Ad] Endereço:Nemours Alfred I duPont Hospital for Children, Nemours Center for Cancer and Blood Disorders, Wilmington, Delaware.
[Ti] Título:Implementing the psychosocial standards in pediatric cancer: Current staffing and services available.
[So] Source:Pediatr Blood Cancer;64(11), 2017 Nov.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards. PROCEDURE: Up to three healthcare professionals from 144 programs (72% response rate) participated in an online survey conducted June-December 2016. There were 99 pediatric oncologists with clinical leadership responsibility (Medical Director/Clinical Director), 132 psychosocial leaders in pediatric oncology (Director of Psychosocial Services/Manager/most senior staff member), and 58 administrators in pediatric oncology (Administrative Director/Business Administrator/Director of Operations). The primary outcomes were number and type of psychosocial staff, psychosocial practices, and identified challenges in the delivery of psychosocial care. RESULTS: Over 90% of programs have social workers and child life specialists who provide care to children with cancer and their families. Fewer programs have psychologists (60%), neuropsychologists (31%), or psychiatrists (19%). Challenges in psychosocial care are primarily based on pragmatic issues related to funding and reimbursement. CONCLUSION: Most participating pediatric oncology programs appear to have at least the basic level of staffing necessary to implement of some of the Standards. However, the lack of a more comprehensive multidisciplinary team is a likely barrier in the implementation of the full set of Standards.
[Mh] Termos MeSH primário: Institutos de Câncer/organização & administração
Pessoal de Saúde/estatística & dados numéricos
Neoplasias/terapia
Serviço Hospitalar de Oncologia/estatística & dados numéricos
Admissão e Escalonamento de Pessoal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Criança
Pessoal de Saúde/psicologia
Seres Humanos
Neoplasias/psicologia
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26634


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[PMID]:28419013
[Au] Autor:Conley SB; Buckley P; Magarace L; Hsieh C; Pedulla LV
[Ad] Endereço:Dana-Farber Cancer Institute, Boston, Massachusetts, and Brigham and Women's Hospital, Boston, Massachusetts. Susanne B. Conley, MSN, RN, CPON, AOCNS®, is an advanced oncology clinical nurse specialist at Dana-Farber Cancer Institute in Boston, Massachusetts, with more than 35 years of clinical, administrative, and educational experience. Ms Conley is responsible for oversight and development of nursing policies and procedures assuring compliance with current practice and regulatory agency requirements. As a clinical nurse specialist for several oncology specialty practices, she is responsible for assuring evidence-based practice and staff training. Ms Conley is active in national organizations and has served as a project team member for the Oncology Nursing Society Institute for Evidence-Based Practice Change. She has published articles and developed curricula on nursing practice, and has spoken extensively on nursing practice issues. Paula Buckley, BSN, RN, is an intravenous (IV) access nurse at Dana-Farber Cancer Institute in Boston. She serves on the venous access committee and precepts new RN staff with IV skills. Lisa Magarace, BSN, RN, is an IV and apheresis specialist and served for 2 years as the full-time charge nurse on the laboratory services unit at Dana-Farber Cancer Institute. Candace Hsieh, BSN, RN, CIC®, is an infection control nurse specialist. She works for the infection control department of both Brigham and Women's Hospital and Dana-Farber Cancer Institute, where she also works in the pediatric oncology department. She oversees surveillance and monitoring of central line-associated bloodstream infections. She also serves on the venous access, infection control, and nursing policy and procedure committees. Lillian Vitale Pedulla, MSN, BSN, RN, NEA-BC, served as the director of laboratory services, developing the nurse IV access team for Dana-Farber Cancer Institute. She served on the adult nursing practice, venous access, and nursing policy and procedure committees.
[Ti] Título:Standardizing Best Nursing Practice for Implanted Ports: Applying Evidence-based Professional Guidelines to Prevent Central Line-Associated Bloodstream Infections.
[So] Source:J Infus Nurs;40(3):165-174, 2017 May/Jun.
[Is] ISSN:1539-0667
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nearly 3 million central vascular access devices (CVADs) are used in the United States each year. These devices are an important advance in health care and essential to oncology patients. However, CVADs are the most frequent cause of central line-associated bloodstream infections (CLABSIs). CLABSI can be prevented when evidence-based practices are followed consistently over time. Professional organizations establish valid standards and guidelines to guide CVAD practice. This article identifies strategies implemented at a comprehensive ambulatory cancer center to integrate professional evidence-based standards and guidelines for implanted port care into nursing practice at the point of care.
[Mh] Termos MeSH primário: Infecções Relacionadas a Cateter/prevenção & controle
Cateterismo Venoso Central/normas
Prática Clínica Baseada em Evidências/normas
Recursos Humanos de Enfermagem/normas
Enfermagem Oncológica/normas
[Mh] Termos MeSH secundário: Assistência Ambulatorial
Bacteriemia/etiologia
Seres Humanos
Serviço Hospitalar de Oncologia
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1097/NAN.0000000000000217


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[PMID]:28391984
[Au] Autor:Joly F; Guillot A; Vano YA; Spaeth D; Topart D; Roffet P; El Amarti R; Hasbini A; Fléchon A
[Ad] Endereço:Centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France. Electronic address: f.joly@baclesse.unicancer.fr.
[Ti] Título:[French national survey on incoming phone calls in oncology departments].
[Ti] Título:Enquête nationale française sur les appels téléphoniques entrants en oncologie médicale..
[So] Source:Bull Cancer;104(6):565-573, 2017 Jun.
[Is] ISSN:1769-6917
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:INTRODUCTION: Oral therapies have shifted the follow-up of patients with cancer from hospital to home. As a consequence, the number of incoming calls has increased. To understand the source, reasons, management and burden of calls, we underwent a French national survey. The objective was to describe the way calls are managed in oncology departments. METHODS: The study was a prospective survey in a representative sample of French oncology specialists using oral therapies. RESULTS: Among 51 participating onco/radiotherapy departments, 86 % of specialists were oncologists or hematologists and 14 % radiation oncologists. Eighty percent were from public centers and 20 % from private ones. The median number of calls/week was 110. Sixty-six percent of calls were from patients and families and 23 % from general practitioners. Upon calls reception by the secretaries, half of them corresponded to a medical question. Sixty-five percent of centers did not have an established specific procedure and 70 % of responders did not specifically train their teams to address the management of calls. Sixty-five percent of the specialists spent more than 30min/day. Most of them considered it disturbing medical activities. Sixty-six percent of patients calls were related to adverse effects of treatments. Twenty-two percent of specialists declared at least one severe adverse effect linked to misinterpretation of a call. DISCUSSION: With the increase of oral therapies, incoming phone calls represent an important burden of work. To improve calls management, adaptations of organizations are needed.
[Mh] Termos MeSH primário: Antineoplásicos/efeitos adversos
Neoplasias/tratamento farmacológico
Serviço Hospitalar de Oncologia/estatística & dados numéricos
Inquéritos e Questionários
Telefone/utilização
[Mh] Termos MeSH secundário: Antineoplásicos/administração & dosagem
Atitude do Pessoal de Saúde
Família
França
Clínicos Gerais/estatística & dados numéricos
Hematologia/estatística & dados numéricos
Seres Humanos
Oncologistas/estatística & dados numéricos
Estudos Prospectivos
Radio-Oncologistas/estatística & dados numéricos
Fatores de Tempo
Carga de Trabalho/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE


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[PMID]:28384314
[Au] Autor:Kullberg A; Sharp L; Johansson H; Brandberg Y; Bergenmar M
[Ad] Endereço:Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:Patient satisfaction after implementation of person-centred handover in oncological inpatient care - A cross-sectional study.
[So] Source:PLoS One;12(4):e0175397, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure. The aim of the study was to compare person-centered handover with non-verbal handover in an oncological inpatient setting with regard to patient satisfaction. A cross-sectional design featuring two points of measurement at one intervention ward and two control wards was applied. The EORTC IN-PATSAT32 questionnaire was used for measuring patient satisfaction. Baseline measurements were taken during the spring of 2014, when all three wards used a non-verbal handover model, and included responses from 116 patients. Follow-up measurements (comparing PCH and non-verbal handover) involved 209 patients and were on-going from September 2014 to May 2015. After the introduction of PCH, one change in patient satisfaction was detected regarding the subscale measuring exchange of information between caregivers. Patients from the intervention ward scored statistically higher after the implementation of PCH when compared to the control wards (p = .0058). The difference remained after a multivariate regression analysis controlling for clinical variables. In conclusion, PCH is feasible in oncological inpatient care but does not seem to affect patient satisfaction.
[Mh] Termos MeSH primário: Pacientes Internados
Serviço Hospitalar de Oncologia/organização & administração
Transferência da Responsabilidade pelo Paciente
Satisfação do Paciente
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175397


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[PMID]:28279420
[Au] Autor:Snipelisky D; Park JY; Lerman A; Mulvagh S; Lin G; Pereira N; Rodriguez-Porcel M; Villarraga HR; Herrmann J
[Ad] Endereço:Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
[Ti] Título:How to Develop a Cardio-Oncology Clinic.
[So] Source:Heart Fail Clin;13(2):347-359, 2017 Apr.
[Is] ISSN:1551-7136
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cardiovascular demands to the care of cancer patients are common and important given the implications for morbidity and mortality. As a consequence, interactions with cardiovascular disease specialists have intensified to the point of the development of a new discipline termed cardio-oncology. As an additional consequence, so-called cardio-oncology clinics have emerged, in most cases staffed by cardiologists with an interest in the field. This article addresses this gap and summarizes key points in the development of a cardio-oncology clinic.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/terapia
Neoplasias/terapia
[Mh] Termos MeSH secundário: Reabilitação Cardíaca
Serviço Hospitalar de Cardiologia
Doenças Cardiovasculares/etiologia
Seres Humanos
Neoplasias/complicações
Serviço Hospitalar de Oncologia
Equipe de Assistência ao Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE


  10 / 1339 MEDLINE  
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[PMID]:28251644
[Au] Autor:Vallance AE; vanderMeulen J; Kuryba A; Botterill ID; Hill J; Jayne DG; Walker K
[Ad] Endereço:Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK.
[Ti] Título:Impact of hepatobiliary service centralization on treatment and outcomes in patients with colorectal cancer and liver metastases.
[So] Source:Br J Surg;104(7):918-925, 2017 Jun.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Centralization of specialist surgical services can improve patient outcomes. The aim of this cohort study was to compare liver resection rates and survival in patients with primary colorectal cancer and synchronous metastases limited to the liver diagnosed at hepatobiliary surgical units (hubs) with those diagnosed at hospital Trusts without hepatobiliary services (spokes). METHODS: The study included patients from the National Bowel Cancer Audit diagnosed with primary colorectal cancer between 1 April 2010 and 31 March 2014 who underwent colorectal cancer resection in the English National Health Service. Patients were linked to Hospital Episode Statistics data to identify those with liver metastases and those who underwent liver resection. Multivariable random-effects logistic regression was used to estimate the odds ratio of liver resection by presence of specialist hepatobiliary services on site. Survival curves were estimated using the Kaplan-Meier method. RESULTS: Of 4547 patients, 1956 (43·0 per cent) underwent liver resection. The 1081 patients diagnosed at hubs were more likely to undergo liver resection (adjusted odds ratio 1·52, 95 per cent c.i. 1·20 to 1·91). Patients diagnosed at hubs had better median survival (30·6 months compared with 25·3 months for spokes; adjusted hazard ratio 0·83, 0·75 to 0·91). There was no difference in survival between hubs and spokes when the analysis was restricted to patients who had liver resection (P = 0·620) or those who did not undergo liver resection (P = 0·749). CONCLUSION: Patients with colorectal cancer and synchronous metastases limited to the liver who are diagnosed at hospital Trusts with a hepatobiliary team on site are more likely to undergo liver resection and have better survival.
[Mh] Termos MeSH primário: Serviços Centralizados no Hospital
Neoplasias Colorretais/patologia
Neoplasias Hepáticas/secundário
Neoplasias Hepáticas/cirurgia
Serviço Hospitalar de Oncologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Feminino
Hepatectomia
Seres Humanos
Lactente
Recém-Nascido
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/mortalidade
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.10501



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